This Monday, June 9, 2014 photo shows the VA Health Care Center in Harlingen, Texas. The medical center ranks high on the list of the facilities with the longest average waits as of May 15, 2014 for new patients seeking primary care, specialist care and mental health care, according to audit results released Monday. (AP Photo/Valley Morning Star, David Pike)

Veterans seeking an initial mental health or specialty care appointment at the Department of Veterans Affairs' El Paso clinic face among the longest wait times in the nation, according to an audit released Monday.

A new patient seeking a mental health appointment waits an average of 60 days before seeing a health-care provider at the El Paso VA, according to the national VA audit. Only three smaller clinics in the VA system have longer waiting times.

U.S. Rep. Beto O'Rourke, D-Texas, said the audit is the first step in solving the problem.

"The first step in solving a problem is admitting you have a problem, which is what the VA has done with this audit," O'Rourke said. "Now they are reporting numbers that are rooted in reality."

The audit also found that established VA patients seeking a mental health appointment in El Paso wait an average of 16 days before getting a requested appointment — by far the longest wait in the nation. The El Paso VA clinic serves veterans in far West Texas and southern New Mexico.

Vets seeking an initial specialty care appointment in El Paso waited an average of 90 days before seeing a provider, the audit found. Only one clinic in the nation, a much smaller one, had a longer wait period for an initial specialty care appointment.

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The audit found that more than 57,000 veterans nationally, including 331 in El Paso, have been waiting 90 days or more for their first VA medical appointments, and an additional 64,000 — including 1,155 in El Paso — appear to have fallen through the cracks, never getting appointments after enrolling and requesting them, the Veterans Affairs Department said Monday.

El Paso veteran and retired 1st Sgt. Nathaniel Ford Jr., who served in the Army from 1958 to 1984, said he wasn't surprised by the long wait times at the El Paso VA clinic.

When he first retired in El Paso from Germany, he said he was able to see a primary-care doctor four times a year at the local VA clinic. The clinic would regularly schedule those visits and then notify you of them, Ford said. That went down to two visits after the Gulf War in 1991 and now you have to make appointments yourself and typically have a three-month wait, he said.

"It seems like there are more patients than doctors," Ford said. "That's the major problem up there."

Ford said that long wait times across the nation are a sign that the VA system is failing veterans "big-time."

"Basically, what this area needs is not a VA clinic, but a VA hospital," said Ford, who saw combat duty twice in Vietnam. "With a hospital, you should be able to get more veterans in a more timely manner."

The audit numbers released Monday for the El Paso office are in line with a survey O'Rourke's office released last week. That survey of local veterans showed that the average wait time for mental-health appointments was 71 days, he said.

O'Rourke said he agrees with Ford's assessment that El Paso needs a full-fledged VA hospital.

"He hit the nail on the head," O'Rourke said. "We don't have the necessary specialty doctor positions and it makes it a lot harder to get them here when you have a clinic, which is what El Paso has, versus a hospital, which is what El Paso needs."

The local VA said in a statement issued late Monday that the agency is committed to transparency.

"And here in El Paso we care deeply for every veteran we are privileged to serve," the statement read. "Our goal is to provide timely access to quality health care our veterans have earned and deserve."

El Paso VA Director John A. Mendoza said, "we have taken great measures to improve access for care."

"We are working aggressively to continue to improve our wait times - and we are doing that one veteran at a time," he said.

Locally, the VA has "begun contacting and scheduling all veterans who are waiting for care," the statement added.

"We are scheduling visits at our VA clinics or arranging for care in the community," it continued. "At the same time, we are simultaneously addressing the underlying issues that might impede veterans' access."

But it's not just a numbers problem. Thirteen percent of schedulers in the facility-by-facility nationwide audit of 731 VA hospitals and outpatient clinics reported being told by supervisors to falsify appointment schedules to make patient waits appear shorter.

The audit is the first nationwide look at the VA network in the uproar that began with reports two months ago of patients dying while awaiting appointments and of cover-ups at the Phoenix VA center. A preliminary audit last month found that long patient waits and falsified records were "systemic" throughout the VA medical network, the nation's largest single health care provider with nearly 9 million veterans and their families as patients.

The controversy forced VA Secretary Eric Shinseki to resign May 30. Shinseki took the blame for what he decried as a "lack of integrity" through the network. Legislation is being written in both the House and Senate to allow more veterans, including those enrolled in Medicare or the military's TRICARE program, to get treatment from outside providers if they can't get timely VA appointments. The proposals also would make it easier to fire senior VA regional officials and hospital administrators.

The audit said a 14-day target for waiting times was "not attainable," given growing demand for VA services and poor planning. It called the 2011 decision by senior VA officials setting it, and then basing bonuses on meeting the target, "an organizational leadership failure."

The audit is the third in a series of reports in the past month on long wait times and falsified records at VA facilities nationwide.

Acting VA Secretary Sloan Gibson said that VA officials have contacted 50,000 veterans across the country to get them off waiting lists and into clinics and are in the process of contacting 40,000 more.

A previous inspector general's investigation into the troubled Phoenix VA Health Care System found that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off an electronic waiting list. While the investigation focused on Phoenix, it pointed to problems throughout the sprawling health care system.

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